Primary erythrocytosis in a bitch - clinical and laboratorial aspects

Background: Primary erythrocytosis is a rare myeloproliferative disorder in dogs and cats characterized by an autonomous proliferation of erythroid precursors in the bone marrow, with low to normal serum erythropoietin concentration, resulting in elevated red blood cell count, hematocrit and hemoglobin concentration. Clinical signs are associated with increased blood volume and viscosity, and may include erythema, hyperemic mucous membranes and neurological signs such as seizures and ataxia. In veterinary medicine, the diagnosis should be made by exclusion of secondary or relative causes, after complementary exams. This report aims to describe a case of primary erythrocytosis in a bitch. Case: A 4-year-old mixed-breed bitch was referred to the Veterinary Medical Teaching Hospital from UFRGS with 3 convulsive episodes related by the owner. A previous abdominal ultrasonography revealed splenomegaly and the electrocardiogram showed no abnormalities. No alterations were observed at the physical examination. The laboratorial blood tests demonstrated a persistent erythrocytosis, with high hematocrit, hemoglobin and red blood cells count, thrombocytopenia and neutropenia, and total plasmatic protein within the reference interval. The bone marrow cytology revealed reduced cellularity, normal myeloid:erythroid ratio, erythroid hyperplasia, mild myeloid hyperplasia and moderate myelofibrosis. The serum erythropoietin measurement was within the reference range, and the blood gas analysis detected a slight decrease in partial oxygen pressure. Therefore, no evidence of secondary conditions was observed and the diagnosis of primary erythrocytosis could be made. Discussion: Since there is no definitive method, the diagnosis of primary erythrocytosis could be based on the exclusion of all secondary and relative causes of erythrocytosis. The absence of clinical signs of dehydration and high serum albumin levels were findings that conduced for the exclusion of the relative form of the disturbance. The echocardiography and the abdominal ultrasonography ruled out any cardiopulmonary condition or kidney neoplasm, the most common causes of absolute secondary erythrocytosis. The persistently high hematocrit levels and red blood cell counts are significant for the suspicion of primary erythrocytosis, although thrombocytopenia and neutropenia are not commonly reported. The clinical signs of seizure were correlated with increased blood viscosity and reduced blood flow at the central nervous system. The blood gas analysis discarded the occurrence of systemic hypoxia, and the normal levels of erythropoietin gives higher evidence of the occurrence of an autonomous proliferation of the erythroid precursors within the bone marrow. The bone marrow cytology confirmed erythroid hyperplasia and the reduced cellularity that could be attributed to myelofibrosis. Myelofibrosis was described in humans with polycythemia vera, but there are no reports in veterinary, and this occurrence must be elucidated. An identical mutation in the JAK2 gene was observed in humans with polycythemia vera and dogs with primary erythrocytosis, and occurs in more than 50% of humans with myelofibrosis. Further investigations are necessary for veterinary medicine. In conclusion, the systematic approach of all organic systems and the assessment of complementary exams are necessary for the diagnostic of primary erythrocytosis in dogs. This condition should be considered in the differential diagnosis of any erythrocytosis, considering the guarded prognosis of this hematologic disorder.

Acute erythroid leukemia in a cat infected with feline leukemia virus

Background: Erythroid leukemia is a myeloproliferative hematopoietic disorder considered acute when there is a predominance of blasts in the bone marrow. It is frequently reported in cats infected with feline leukemia virus, but it is unclear whether this virus is involved in the oncogenesis. The clinical signs in cats are anorexia, apathy, weight loss, with evolution from 2 weeks to 2 months, pale mucous membranes, hemorrhages, ascites, salivation, and dyspnea due to pleural effusion. This affection responds little to chemotherapy with an unfavorable prognosis. The aim of this study is to report a case of a feline leukemia virus infected cat with the onset of severe hemolytic anemia. Case: A 8-year-old male mixed breed cat was attended with a history of anorexia, oligodipsia, apathy, progressive weight loss, and yellowish color of urine for 7 days. Laboratorial exams showed anemia (with metarubricytes, acanthocytes and ghost cells), leukocytosis and FeLV reagent test. The cat underwent treatment with methylprednisolone acetate and supportive care. One day later, the animal returned with icteric mucous membranes, and emesis. A blood count was performed that found worsening anemia, increased leukocytosis, and lymphocytosis. Abdominal ultrasound showed cholangiohepatitis and lymphadenomegaly in mesenteric lymph nodes. Treatment was started with ondansetron, metronidazole, and amoxicilin with potassium clavulanate. The cat returned after 3 days and laboratorial exams revealed worsening of blood parameters, so blood transfusion was performed. After 2 days, the patient started with dyspnea and hypothermia, that evolved to cardiorespiratory arrest. The body was sent to necropsy and histopathology, where blast cells and rubricytes were found in blood vessels of various organs. The bone marrow was markedly cellular with complete disappearance of adipose tissue. Most of the cells were blasts with abundant and eosinophilic cytoplasm, central nucleus with finely dotted chromatin and a large nucleolus. There were rubricytes, which made possible to confirm acute erythroid leukemia as a morphological diagnosis. Discussion: The clinical signs observed in acute erythroid leukemia are lethargy, inappetence, fever, splenomegaly, mild lymphadenomegaly, associated with leukocytosis, severe anemia, and thrombocytopenia. The reported animal presented signs similar to those described in the literature except that there was no change in platelet counts. The diagnosis of leukemia was reached after histopathology, and it is made when is observed more than 30% of myeloblasts and monoblasts together or when the blast cells count including rubriblasts is greater than 30%. Although chemotherapy, the prognosis is usually poor. It is essential to perform the myelogram for the diagnosis of myeloid leukemias in vivo. In this report, we only achieve final diagnosis after the cat's death, due to the aggressive behavior of the disease. Clinicians must be aware of the likely development of acute erythroid leukemia whenever a feline leukemia virus infected cat presents hemolytic anemia to get an early diagnosis, since this is an extremely aggressive disease, to propose prompt chemotherapy and give the patient a longer survival period.

Rare and unknown canine systemic mastocytosis: clinical and laboratory features of an aberrant c-Kit mutation neoplasia / A rara e desconhecida mastocitose sistêmica canina: características clínicas e laboratoriais de uma neoplasia aberrante na mutação c-Kit

Systemic mastocytosis (SM) pathology is extremely rare in canine practice, with insufficient reported data. The knowledge of the clinical behavior of this pathology is scarce. In human medicine, SM has been widely investigated, being defined as a rare hematopoietic disorder by the World Health Organization (2016), within the type of myeloproliferative neoplasms. Herein, we describe a systemic mastocytosis case in a Portuguese Serra-da-Estrela dog, where a cutaneous grade III/high-grade MCT was also diagnosed. The clinical decline of the animal and owner's insistence throughout anamnesis that the dog was markedly different after the cytologic exam performed in another clinic, along with both severe eosinophilia and hepatomegaly, led to the clinical suspicion of SM. The animal passed away 7 days later. Post-morteminvestigation confirmed SM pathology, and a deletion of 15 base pairs change on c-Kit gene exon 11 was identified. Contemplating the low number of cases described in the literature, this publication aims to disclose clinical and laboratory features of rare and poorly described canine SM, taking into consideration human outcomes described in the literature.(AU)

A patologia da mastocitose sistêmica (SM) é extremamente rara na prática clínica canina, com escassos casos descritos na literatura científica. O conhecimento do comportamento clínico desta patologia é mínimo. Na medicina humana, a SM tem sido amplamente investigada, sendo definida como uma doença hematopoiética rara pela Organização Mundial da Saúde (2016), dentro do tipo de neoplasias mieloproliferativas. Descrevemos aqui um caso de mastocitose sistêmica num cão Serra-da-Estrela português, diagnosticado também com um mastocitoma cutâneo grau III / alto grau. O declínio clínico do animal e a insistência do proprietário durante a anamnese de que o cão estava marcadamente diferente após o exame citológico realizado em outra clínica, juntamente com eosinofilia e hepatomegalia graves, levantaram a suspeita clínica de SM. O animal faleceu 7 dias depois. A investigação post-mortem confirmou a patologia SM, e o estudo molecular revelou uma deleção de 15 pares de bases no exon 11 do gene c-Kit. Contemplando o baixo número de casos descritos na literatura, o objetivo desta publicação é divulgar características clínicas e laboratoriais de SM canina, levando em consideração informações clínicas descritas em humanos.(AU)

Rare and unknown canine systemic mastocytosis: clinical and laboratory features of an aberrant c-Kit mutation neoplasia / A rara e desconhecida mastocitose sistêmica canina: características clínicas e laboratoriais de uma neoplasia aberrante na mutação c-Kit

Systemic mastocytosis (SM) pathology is extremely rare in canine practice, with insufficient reported data. The knowledge of the clinical behavior of this pathology is scarce. In human medicine, SM has been widely investigated, being defined as a rare hematopoietic disorder by the World Health Organization (2016), within the type of myeloproliferative neoplasms. Herein, we describe a systemic mastocytosis case in a Portuguese Serra-da-Estrela dog, where a cutaneous grade III/high-grade MCT was also diagnosed. The clinical decline of the animal and owner's insistence throughout anamnesis that the dog was markedly different after the cytologic exam performed in another clinic, along with both severe eosinophilia and hepatomegaly, led to the clinical suspicion of SM. The animal passed away 7 days later. Post-morteminvestigation confirmed SM pathology, and a deletion of 15 base pairs change on c-Kit gene exon 11 was identified. Contemplating the low number of cases described in the literature, this publication aims to disclose clinical and laboratory features of rare and poorly described canine SM, taking into consideration human outcomes described in the literature.(AU)

A patologia da mastocitose sistêmica (SM) é extremamente rara na prática clínica canina, com escassos casos descritos na literatura científica. O conhecimento do comportamento clínico desta patologia é mínimo. Na medicina humana, a SM tem sido amplamente investigada, sendo definida como uma doença hematopoiética rara pela Organização Mundial da Saúde (2016), dentro do tipo de neoplasias mieloproliferativas. Descrevemos aqui um caso de mastocitose sistêmica num cão Serra-da-Estrela português, diagnosticado também com um mastocitoma cutâneo grau III / alto grau. O declínio clínico do animal e a insistência do proprietário durante a anamnese de que o cão estava marcadamente diferente após o exame citológico realizado em outra clínica, juntamente com eosinofilia e hepatomegalia graves, levantaram a suspeita clínica de SM. O animal faleceu 7 dias depois. A investigação post-mortem confirmou a patologia SM, e o estudo molecular revelou uma deleção de 15 pares de bases no exon 11 do gene c-Kit. Contemplando o baixo número de casos descritos na literatura, o objetivo desta publicação é divulgar características clínicas e laboratoriais de SM canina, levando em consideração informações clínicas descritas em humanos.(AU)

Acute myeloid leukemia in a dog chronically infected with leishmania spp. and other infectious agents / Leucemia mieloide aguda em cão infectado cronicamente por Leishmania spp. e outros agentes infecciosos

Background: Rare studies have described the association of hematopoietic tumors and canine visceral leishmaniosis, however the association between the parasitary disease and neoplasia is still not well established in dogs. Thus, the aim of the present study was to report a case of acute myeloid leukemia (AML) in a dog infected by Leishmania spp. and other infectious agents.Case: A 8-year-old, male Poodle, was brought to the Veterinary Hospital from Universidade Federal Rural do Semi-Árido. The dog had a history of recurrent tick-borne diseases, such as anaplasmosis, over the previous ten months. On physical examination, pale mucosa, enlargement of popliteal lymph nodes, onychogryphosis, purulent nasal discharge, and bilateral blepharitis with purulent discharge were observed. The dog was skinny and infested with ticks. The blood cell count revealed normocytic, normochromic anemia and leukocytosis (38.000/mm3 ) with neutrophilia (30.020/mm3 ). Serum biochemical tests demonstrated hyperproteinemia due to hyperglobulinemia, hypoalbuminemia, and an albumin:globulin ratio of 0.30. The immunochromathographic test for leishmaniasis was negative. The alterations observed in the bone marrow cytological analysis were suggestive of AML, and Anaplasma spp., Hepatozoon spp., and amastigote forms of Leishmania spp. were observed inside bone marrow cells. After diagnosis, a decision to euthanize the animal was made.Discussion: Few studies have demonstrated the presence of hematopoietic neoplasia in dogs chronically and simultaneously infected with multiple pathogens. A case of multiple myeloma in a dog associated with infection by Ehrlichia canis, A. phagocytophilum, L. infantum, and Dirofilaria immitis is described. Another study reported B-cell lymphoma in a dog with E. canis and Histoplasma capsulatum infection.[...]

Acute myeloid leukemia in a dog chronically infected with leishmania spp. and other infectious agents / Leucemia mieloide aguda em cão infectado cronicamente por Leishmania spp. e outros agentes infecciosos

Background: Rare studies have described the association of hematopoietic tumors and canine visceral leishmaniosis, however the association between the parasitary disease and neoplasia is still not well established in dogs. Thus, the aim of the present study was to report a case of acute myeloid leukemia (AML) in a dog infected by Leishmania spp. and other infectious agents.Case: A 8-year-old, male Poodle, was brought to the Veterinary Hospital from Universidade Federal Rural do Semi-Árido. The dog had a history of recurrent tick-borne diseases, such as anaplasmosis, over the previous ten months. On physical examination, pale mucosa, enlargement of popliteal lymph nodes, onychogryphosis, purulent nasal discharge, and bilateral blepharitis with purulent discharge were observed. The dog was skinny and infested with ticks. The blood cell count revealed normocytic, normochromic anemia and leukocytosis (38.000/mm3 ) with neutrophilia (30.020/mm3 ). Serum biochemical tests demonstrated hyperproteinemia due to hyperglobulinemia, hypoalbuminemia, and an albumin:globulin ratio of 0.30. The immunochromathographic test for leishmaniasis was negative. The alterations observed in the bone marrow cytological analysis were suggestive of AML, and Anaplasma spp., Hepatozoon spp., and amastigote forms of Leishmania spp. were observed inside bone marrow cells. After diagnosis, a decision to euthanize the animal was made.Discussion: Few studies have demonstrated the presence of hematopoietic neoplasia in dogs chronically and simultaneously infected with multiple pathogens. A case of multiple myeloma in a dog associated with infection by Ehrlichia canis, A. phagocytophilum, L. infantum, and Dirofilaria immitis is described. Another study reported B-cell lymphoma in a dog with E. canis and Histoplasma capsulatum infection.[...](AU)

Eritrocitose primária em cão: relato de caso / Primary erythrocytosis in dog: case report

A eritrocitose absoluta primária, também denominada de policitemia vera, é um distúrbio mieloproliferativo crônico de causa desconhecida, caracterizado pela proliferação clonal de células-tronco eritróides neoplásicas. Acomete cães de meia-idade entre seis e sete anos. As manifestações clínicas mais comuns são letargia, fraqueza, poliúria, polidipsia, sangramentos como epistaxe, hematúria, hematoemese, hematoquezia, até mesmo convulsões e ataxia. O diagnóstico é baseado em valores altos de hematócrito, geralmente acima de 70%, excluindo-se as causas de eritrocitose secundária. As concentrações séricas de eritropoietina estão normais ou diminuídas. O tratamento consiste em flebotomia e administração de hidroxiuréia. Relata-se o caso de uma cadela, raça Bichon Frise, 11 anos, que, no início do quadro, apresentou hematócrito de 84%, letargia, ataxia, mucosas congestas, cianose de língua, poliúria e polidipsia. Realizou-se o tratamento com hidroxiuréia durante oito anos, na dose de 15 a 30 mg/kg, a cada 24 horas, sem ocorrência de efeitos colaterais ou recidiva das manifestações clínicas.(AU)

Primary absolute erythrocytosis, also termed polycythemia vera, is a chronic myeloproliferative disorder of unknown cause. It is characterized by clonal proliferation of neoplastic erythroid stem cells. It affects middle-aged dogs between 6-7 years. The most common clinical manifestations are lethargy, weakness, polyuria, polydipsia, and bleeding such as epistaxis, hematuria, hematoemese, and hematochezia. Seizures and ataxia are also common. Diagnosis is based on high hematocrit values, generally above 70% excluding the causes of secondary erythrocytosis. Serum concentrations of erythropoietin are at a normal level or decreased level. Treatments consists of hydroxyurea and phlebotomy management. It is reported that case of female Bichon Frise, 11 years old who onset of the disease had a hematocrit of 84%, lethargy, ataxia, congested mucous membranes, tongue cyanosis, polyuria and polydipsia. The treatment with hydroxyurea was performed for 8 years, at a dose of 15 to 20mg/kg, every 24 hours, without occurrence of side effects or recurrence of clinical manifestations.(AU)

Eritrocitose primária em cão: relato de caso / Primary erythrocytosis in dog: case report

A eritrocitose absoluta primária, também denominada de policitemia vera, é um distúrbio mieloproliferativo crônico de causa desconhecida, caracterizado pela proliferação clonal de células-tronco eritróides neoplásicas. Acomete cães de meia-idade entre seis e sete anos. As manifestações clínicas mais comuns são letargia, fraqueza, poliúria, polidipsia, sangramentos como epistaxe, hematúria, hematoemese, hematoquezia, até mesmo convulsões e ataxia. O diagnóstico é baseado em valores altos de hematócrito, geralmente acima de 70%, excluindo-se as causas de eritrocitose secundária. As concentrações séricas de eritropoietina estão normais ou diminuídas. O tratamento consiste em flebotomia e administração de hidroxiuréia. Relata-se o caso de uma cadela, raça Bichon Frise, 11 anos, que, no início do quadro, apresentou hematócrito de 84%, letargia, ataxia, mucosas congestas, cianose de língua, poliúria e polidipsia. Realizou-se o tratamento com hidroxiuréia durante oito anos, na dose de 15 a 30 mg/kg, a cada 24 horas, sem ocorrência de efeitos colaterais ou recidiva das manifestações clínicas.(AU)

Primary absolute erythrocytosis, also termed polycythemia vera, is a chronic myeloproliferative disorder of unknown cause. It is characterized by clonal proliferation of neoplastic erythroid stem cells. It affects middle-aged dogs between 6-7 years. The most common clinical manifestations are lethargy, weakness, polyuria, polydipsia, and bleeding such as epistaxis, hematuria, hematoemese, and hematochezia. Seizures and ataxia are also common. Diagnosis is based on high hematocrit values, generally above 70% excluding the causes of secondary erythrocytosis. Serum concentrations of erythropoietin are at a normal level or decreased level. Treatments consists of hydroxyurea and phlebotomy management. It is reported that case of female Bichon Frise, 11 years old who onset of the disease had a hematocrit of 84%, lethargy, ataxia, congested mucous membranes, tongue cyanosis, polyuria and polydipsia. The treatment with hydroxyurea was performed for 8 years, at a dose of 15 to 20mg/kg, every 24 hours, without occurrence of side effects or recurrence of clinical manifestations.(AU)

Fine needle aspiration cytology in feline skeletal muscle as a diagnostic tool for extramedullary plasmacytoma / Citologia aspirativa por agulha fina no músculo esquelético felino como ferramenta diagnóstica para o plasmocitoma extramedular

Extramedullary noncutaneous plasmacytoma (ENP) is a myeloproliferative disorder of plasma cells that rarely affects cats. This paper describes an ENP case revealed by fine needle aspiration cytology (FNAC) of the mass in the skeletal muscle of an 8-month-old, male, mixed breed cat, which had a nodule in the left hind limb. The rapid immunoassay test confirmed the presence of feline leukemia virus (FeLV). The animal necropsy macroscopically showed the nodule came from the semimembranosus muscle. Histopathological examination ratified the cytological findings. Thus, this paper alerts to the existence of plasmacytoma located in the skeletal muscle of feline species. FNAC is a quick and efficient method for diagnosis of ENP.(AU)

O plasmocitoma extramedular (PEM) não cutâneo é um distúrbio mieloproliferativo de plasmócitos que raramente acomete felinos. Este trabalho descreve um caso de PEM no músculo esquelético de um gato, macho, sem raça definida, de oito meses de idade, que apresentava um aumento de volume no membro pélvico esquerdo. A citologia aspirativa por agulha fina (CAAF) da massa revelou tratar-se de PEM. O teste imunoenzimático rápido confirmou a presença do vírus da leucemia felina (FeLV). Na necropsia do animal, macroscopicamente, percebeu-se que o nódulo era originário do músculo semimembranoso. O exame histopatológico ratificou os achados citológicos. Desta forma, alerta-se para a existência de plasmocitoma com localização em músculo esquelético na espécie felina, sendo a CAAF um método alternativo rápido e eficaz para o seu diagnóstico.(AU)

Fine needle aspiration cytology in feline skeletal muscle as a diagnostic tool for extramedullary plasmacytoma / Citologia aspirativa por agulha fina no músculo esquelético felino como ferramenta diagnóstica para o plasmocitoma extramedular

Extramedullary noncutaneous plasmacytoma (ENP) is a myeloproliferative disorder of plasma cells that rarely affects cats. This paper describes an ENP case revealed by fine needle aspiration cytology (FNAC) of the mass in the skeletal muscle of an 8-month-old, male, mixed breed cat, which had a nodule in the left hind limb. The rapid immunoassay test confirmed the presence of feline leukemia virus (FeLV). The animal necropsy macroscopically showed the nodule came from the semimembranosus muscle. Histopathological examination ratified the cytological findings. Thus, this paper alerts to the existence of plasmacytoma located in the skeletal muscle of feline species. FNAC is a quick and efficient method for diagnosis of ENP.(AU)

O plasmocitoma extramedular (PEM) não cutâneo é um distúrbio mieloproliferativo de plasmócitos que raramente acomete felinos. Este trabalho descreve um caso de PEM no músculo esquelético de um gato, macho, sem raça definida, de oito meses de idade, que apresentava um aumento de volume no membro pélvico esquerdo. A citologia aspirativa por agulha fina (CAAF) da massa revelou tratar-se de PEM. O teste imunoenzimático rápido confirmou a presença do vírus da leucemia felina (FeLV). Na necropsia do animal, macroscopicamente, percebeu-se que o nódulo era originário do músculo semimembranoso. O exame histopatológico ratificou os achados citológicos. Desta forma, alerta-se para a existência de plasmocitoma com localização em músculo esquelético na espécie felina, sendo a CAAF um método alternativo rápido e eficaz para o seu diagnóstico.(AU)

Leucemia linfoblástica aguda em um cão / Acute Lymphoblastic Leukemia in a Dog

Background: Leukemias are malign neoplasias of the hematopoietic precursor cells from the bone marrow. These neoplastic cells may or may not reach the blood circulation. Leukemias are classified as lymphoid or myeloid depending on the leukocyte cell lineage affected. In addition, leukemias are classified as either acute or chronic based on their cellular differentiation and proliferative aggressiveness. The leukemias from lymphoid cells that affect dogs include acute lymphoblastic leukemia and chronic lymphocytic leukemia. This paper describes the clinical and laboratorial findings of a case of acute lymphoblastic leukemia in a female dog. Case: A seven-year-old female mixed-breed dog was referred to the Veterinary Hospital of the Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, State of Rio Grande do Norte, Brazil, for apathy, anorexia, weakness and weight loss. The clinical examination confirmed the apathy and weakness. The mucous membranes were pale, the body temperature was 40.5°C, the heart rate was 120 bpm, the capillary refill time was 2 s, and no abnormalities were found on auscultation. Diagnostic laboratory tests were completed, including a serum test for canine leishmaniasis, a serum biochemistry panel, a complete blood cell count, and a bone marrow analysis. The canine leishmaniasis serology (enzyme-linked immunosorbent assay and indirect fluorescent-antibody test) was negative. The serum biochemistry panel revealed an increased level of aspartate aminotransferase (AST - 56.0 U/l), hypocalcemia (6.9 mg/dL), hypoalbuminemia (1.91 g/dL), hypobetaglobulinemia (0.51 g/dL), hypergammaglobulinemia (2.91 g/dL), and a decreased albumin/globulin (A/G) ratio (0.41). The observed hematological changes included a normocytic normochromic anemia (RBC = 2.55 x 106/mm³ , hemoglobina = 5.8 g/dL, PCV = 18%), leukocytosis (332,800/mm³) with a left shift (3,328/mm³), eosinopenia (0), monocytosis (6,656/mm³), lymphocytosis (89,856/mm³) with a pronounced presence of lymphoblasts (226,304/mm³) and thrombocytopenia (10 x 103/mm³). The blood smear evaluation revealed anisocytosis, polychromasia, hypochromia, giant platelets, smudge cells and lymphoid cells showing predominantly cytoplasmic basophilia, coarse nuclear chromatin, atypical nucleoli, asynchrony of cell maturation and degenerative cytoplasmic vacuolization, and lymphocytes with donut-shaped nuclei. The analysis of a sternal-puncture bone marrow sample revealed that the bone marrow was diffusely occupied by neoplasic lymphoblasts. Discussion: The anemia and thrombocytopenia observed in this female dog can be attributed to the growth of neoplastic cells in the bone marrow. Another finding was the presence of smudge cells, which are broken degenerated leukocytes, and the presence of these cells in large numbers has been described in humans with chronic lymphocytic leukemia or acute lymphoblastic leukemia. The observed hypoalbuminemia, hypergammaglobulinemia and reduced A/G ratio are probably due to the infl ammatory process stimulated by the leukemia. In fact, albumin is a negative acute phase protein, while an increased production of antibodies results in the increased γ-globulins. The prognosis for acute lymphoblastic leukemia is grave, as it is typically rapidly fatal. In humans, the occurrence of hypocalcemia and large number of smudge cells in cases of acute leukemia indicates a worse prognosis. In fact, this patient died one week after her clinical presentation.

Visceral Mast Cell Tumor and Mastocythemia in a Dog

Mast cell tumor manifests as a localized proliferation of mast cells in the skin, or less frequently as a systemic disorder, which may be accompanied by the presence of neoplastic mast cells in the peripheral blood (mastocythemia). In some cases, the neoplastic circulating mast cells originate in the bone marrow, designated as mast cell leukemia, rarely observed in dogs, or the cells may arise from visceral mast cell tumors, characterizing systemic mastocytosis. The aim of this report was to describe a case of a six-year-old female German shepherd dog presenting with history of anorexia, hematemesis and diarrhea. The blood work revealed intense mastocythemia (43%), with degranulated mast cells, and anisocytosis. At necropsy, white nodular lesions in the thymic region and an infiltrative mass in mesenteric and abdominal lymph nodes were observed. Those lymph nodes were enlarged and off-white. Histopathological examination revealed neoplastic mast cells in the liver, spleen, lymph nodes, kidneys, lungs, gastric and enteric mucosae, and adrenal glands. The clinical, hematological and histopathological findings were compatible with mastocythemia, associated with a moderately differentiated visceral mast cell tumor.(AU)

Policitemia vera e farmacodermia em cão – relato de caso / Polycythemia vera and cutaneous drug reaction in a dog – a case report / Policitemia vera y farmacodermia en perro – relato de caso

A policitemia vera é distúrbio mieloproliferativo que se caracteriza pelo aumento do número de hemácias, do volume globular e da concentração de hemoglobina. O tratamento visa reduzir o aumento de células da linhagem eritroide, a hiperviscosidade sanguínea, a formação de trombos e a má oxigenação tecidual. Nesses casos, preconiza-se a hidroxiuréia. Virtualmente, qualquer medicamento pode desencadear farmacodermia, incluindo a hidroxiureia. Em seres humanos as reações que o uso prolongado de hidroxiureia pode ocasionar na pele estão bem documentadas. Neste trabalho relata-se o caso de um cão, macho, sem raça definida, de dez anos de idade, com policitemia vera, que estava sendo tratado com hidroxiureia e apresentou farmacodermia. Com a redução da dosagem de hidroxiureia, houve recuperação da pele; entretanto, o animal morreu por tromboembolismo após um ano.

Polycythemia vera is a myeloproliferative disorder characterized by an increase in the number of erythrocytes, the packed cell volume and hemoglobin concentration. The treatment aims to reduce the increase in the number of cells of erythroid lineage, thrombus formation and poor tissue oxygenation. In these cases, the use of hydroxyurea is recommended. However, virtually any drug can trigger adverse drug reactions, including hydroxyurea. Skin reactions caused by long-term therapy with hydroxyurea are well documented in humans. This work reports the case of a ten-year-old mixed-breed male dog with polycythemia vera that presented pharmacodermia due to treatment with hydroxyurea. Although the skin recovered with the reduction in the dosage of hydroxyurea, the animal died due to thromboembolism.

La policitemia vera es un trastorno mieloproliferativo que se caracteriza por un aumento en el número de eritrocitos, del volumen globular y de la concentración de hemoglobina. El tratamiento trata de reducir el aumento de células de la línea eritroide, la hiperviscosidad sanguínea, la formación de trombos y la deficiente oxigenación de los tejidos. En esos casos está indicada la hidroxiurea. En humanos, las reacciones dermatológicas que puede provocar el uso prolongado de la hidroxiurea se encuentran bien documentadas. En este trabajo se relata el caso de un perro macho, mestizo de diez años, con policitemia vera, que estaba siendo tratado con hidroxiurea y presentó una farmacodermia. Con la disminución de la dosis de hidroxiurea, la piel se recuperó; no obstante, el animal murió por tromboembolismo después de un año.

Policitemia vera e farmacodermia em cão relato de caso / Polycythemia vera and cutaneous drug reaction in a dog a case report / Policitemia vera y farmacodermia en perro relato de caso

A policitemia vera é distúrbio mieloproliferativo que se caracteriza pelo aumento do número de hemácias, do volume globular e da concentração de hemoglobina. O tratamento visa reduzir o aumento de células da linhagem eritroide, a hiperviscosidade sanguínea, a formação de trombos e a má oxigenação tecidual. Nesses casos, preconiza-se a hidroxiuréia. Virtualmente, qualquer medicamento pode desencadear farmacodermia, incluindo a hidroxiureia. Em seres humanos as reações que o uso prolongado de hidroxiureia pode ocasionar na pele estão bem documentadas. Neste trabalho relata-se o caso de um cão, macho, sem raça definida, de dez anos de idade, com policitemia vera, que estava sendo tratado com hidroxiureia e apresentou farmacodermia. Com a redução da dosagem de hidroxiureia, houve recuperação da pele; entretanto, o animal morreu por tromboembolismo após um ano.(AU)

Polycythemia vera is a myeloproliferative disorder characterized by an increase in the number of erythrocytes, the packed cell volume and hemoglobin concentration. The treatment aims to reduce the increase in the number of cells of erythroid lineage, thrombus formation and poor tissue oxygenation. In these cases, the use of hydroxyurea is recommended. However, virtually any drug can trigger adverse drug reactions, including hydroxyurea. Skin reactions caused by long-term therapy with hydroxyurea are well documented in humans. This work reports the case of a ten-year-old mixed-breed male dog with polycythemia vera that presented pharmacodermia due to treatment with hydroxyurea. Although the skin recovered with the reduction in the dosage of hydroxyurea, the animal died due to thromboembolism.(AU)

La policitemia vera es un trastorno mieloproliferativo que se caracteriza por un aumento en el número de eritrocitos, del volumen globular y de la concentración de hemoglobina. El tratamiento trata de reducir el aumento de células de la línea eritroide, la hiperviscosidad sanguínea, la formación de trombos y la deficiente oxigenación de los tejidos. En esos casos está indicada la hidroxiurea. En humanos, las reacciones dermatológicas que puede provocar el uso prolongado de la hidroxiurea se encuentran bien documentadas. En este trabajo se relata el caso de un perro macho, mestizo de diez años, con policitemia vera, que estaba siendo tratado con hidroxiurea y presentó una farmacodermia. Con la disminución de la dosis de hidroxiurea, la piel se recuperó; no obstante, el animal murió por tromboembolismo después de un año.(AU)

Visceral mast cell tumor and mastocythemia in a dog

Mast cell tumor manifests as a localized proliferation of mast cells in the skin, or less frequently as a systemic disorder, which may be accompanied by the presence of neoplastic mast cells in the peripheral blood (mastocythemia). In some cases, the neoplastic circulating mast cells originate in the bone marrow, designated as mast cell leukemia, rarely observed in dogs, or the cells may arise from visceral mast cell tumors, characterizing systemic mastocytosis. The aim of this report was to describe a case of a six-year-old female German shepherd dog presenting with history of anorexia, hematemesis and diarrhea. The blood work revealed intense mastocythemia (43%), with degranulated mast cells, and anisocytosis. At necropsy, white nodular lesions in the thymic region and an infiltrative mass in mesenteric and abdominal lymph nodes were observed. Those lymph nodes were enlarged and off-white. Histopathological examination revealed neoplastic mast cells in the liver, spleen, lymph nodes, kidneys, lungs, gastric and enteric mucosae, and adrenal glands. The clinical, hematological and histopathological findings were compatible with mastocythemia, associated with a moderately differentiated visceral mast cell tumor.